Top PDF Factors affecting reading speed in patients with diabetic macular edema treated with laser photocoagulation.

Factors affecting reading speed in patients with diabetic macular edema treated with laser photocoagulation.

Factors affecting reading speed in patients with diabetic macular edema treated with laser photocoagulation.

Methods: Consecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME) at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co- morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA), contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography.
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Efficacy of anti-VEGF and laser photocoagulation in the treatment of visual impairment due to diabetic macular edema: a systematic review and network meta-analysis.

Efficacy of anti-VEGF and laser photocoagulation in the treatment of visual impairment due to diabetic macular edema: a systematic review and network meta-analysis.

To test the sensitivity of the results to the systematic review and meta-analysis methodology, a number of sensitivity analyses were conducted. Baseline BCVA and CRT have been shown to have an effect on the level of improvements in BCVA in patients treated with anti-VEGF for DME and NICE considers baseline CRT an important clinical variable in the treatment of DME [23,48]. Therefore, the present analysis included baseline BCVA and/or CRT as covariates in the models. A number of candidate models were constructed with either fixed or random treatment effects and including as covariates baseline BCVA, baseline CRT, both BCVA and CRT, or neither parameter. The interaction coefficients between treatment and covariates were assumed to be the same for all treatment arms in the base-case analysis, but were varied in sensitivity analyses. First, the assumption of exchangeable coefficients across treatments was tested (i.e. the coefficient of baseline BCVA was drawn from a normal distribution rather than being a constant value). Second, to capture the potential impact of baseline BCVA differing by treatment, the effect of baseline BCVA was allowed to vary between anti-VEGF treatment and other treatments (laser or sham). The candidate models were assessed using the deviance information criterion (DIC), total residual deviance and available evidence in the literature. More specifically, the posterior mean of the total residual deviance was compared with the number of unconstrained points [49]. A difference in DIC of more than 3–5 points between two models was considered significant and the model with the lowest DIC was elected the better model [50]. If the difference in DIC between two models was 3 points or less, the authors used the total residual deviance and the clinical evidence published in the literature to elect the better model.
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The evaluation of efficacy of subtenon triamcinolone injection combined with focal laser photocoagulation in diabetic macular edema

The evaluation of efficacy of subtenon triamcinolone injection combined with focal laser photocoagulation in diabetic macular edema

Materials and methods: Medical records of patients with DME, treated with 40 mg subtenon injection of triamcino- lone acetonid prior to focal laser photocoagulation were retrospectively analyzed. Seventeen eyes of 17 patients with DME were enrolled in the study. All patients under- went a comprehensive ophthalmological examination before the treatment. Eficacy of the treatment after ST injection was evaluated by visual acuity and lourescein angiography (FA). Follow-up visits were performed at 1 st ,

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Comparação nas alterações da espessura da camada de fibras nervosas retinianas após cirurgia de buraco macular

Comparação nas alterações da espessura da camada de fibras nervosas retinianas após cirurgia de buraco macular

Changes in RNFL thickness from baseline to postope- ratively and averages of the absolute values of the RNFL thickness obtained by sectoral analyses are shown in table 1. No statistically significant difference (p≥0.05) was seen between pre- and post-treatment measurements in relation to each RNFL variable, i.e., on an avera- ge, the pre-treatment measurements are the same as post-treatment measurements. Further, despite the po- sitive differences between the pre- and post-treatment measurements (pre-post>0), these differences were not statistically significant. As shown in figures 2 and 3, the averages of each of the RNFL variables for pre-treatment are higher than those for post-treatment, but this was not statistically significant (p≥0.05).
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Correlation between responses to intravitreal injection of anti-VEGF and diabetic retinopathy extent in diabetic macular edema patients

Correlation between responses to intravitreal injection of anti-VEGF and diabetic retinopathy extent in diabetic macular edema patients

誗 METHODS: This study comprised 33 eyes of 27 non proliferative diabetic retinopathy ( NPDR) patients with DME and 34 eyes of 32 PDR patients with DME, who had been followed for at least 6mo after IVR. We compared the responses to the anti - VEGF treatment between the two groups.

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Clinics  vol.60 número4

Clinics vol.60 número4

edema but no retinal neovascularization (Fig.1). An intravitreal triamcinolone injection was proposed initially for the right eye. An intravitreal injection of 4 mg (0.1 mL) triamcinolone acetonide (Kenalog-40, Apothecon, Princeton, NJ) was performed through the pars plana. After the procedure (October 17, 2003), her vision did not im- prove despite the partial drying of the macula, and the intraocular pressure ranged from 12 to18 mm Hg up to Feb- ruary 25, 2004. The LE was treated only with extra periph- eral and macular photocoagulation. On March 10, 2004, the patient returned with a severe pain in the RE associated with nausea. Iris neovascularization, cornea edema with poorly visible fundus, and an IOP of 54 mm Hg was de- tected. A second intravitreal injection of 4 mg triamci- nolone was given on that day, along with transconjunctival cryotherapy in the peripheral retina (5 applications per quadrant). The medical treatment comprised 0.5% timolol maleate and 1% atropine locally and oral acetazolamide. After 2 days, the patient returned with no pain, an IOP of
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Prevalence of Dental Caries in Type 1 Diabetic Patients Treated with Insulin Pump

Prevalence of Dental Caries in Type 1 Diabetic Patients Treated with Insulin Pump

Material and Methods: An observational clinical study of analytical and cross-sectional nature was conducted. The sample consisted of 30 adults with diabetes mellitus treated with insulin pump (selected from the Coimbra Hospital and Universitary Centre) and 30 non- diabetic adults (selected from the ones accompanying the diabetic patients). One dentist evaluated all of the patients between January and May of 2015 in the Faculty of Medicine of the University of Coimbra. During the clinical evaluation a case report form adapted to the objectives of the investigation was completed. Data analysis was performed and the significance level was set at 5%.
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Arq. Bras. Oftalmol.  vol.73 número2

Arq. Bras. Oftalmol. vol.73 número2

Objetivos: Avaliar as causas de interrupção do tratamento com bevacizumab intravítreo nos pacientes portadores da forma exsudativa de degeneração macular relacionada à idade acompanhados no Hospital de Olhos “Sadalla Amin Ghanem”, em Joinville (SC). Métodos: Série de casos retros- pectiva, consecutiva e não-comparativa. Incluíram-se os pa- cientes com degeneração macular relacionada à idade ex- sudativa tratados com uma ou mais injeções intravítreas de bevacizumab entre janeiro de 2006 e janeiro de 2008. Os dados foram obtidos dos prontuários dos pacientes e de entrevistas telefônicas. O critério de descontinuação foi a ausência do paciente à consulta após o mínimo de três meses a partir da última avaliação oftalmológica. Resultados: Den- tre os 82 pacientes tratados, 24 interromperam o tratamento inadvertidamente (29,3%). A média de idade foi 75,2 anos (65-89 anos). O número médio de injeções intravítreas de bevacizumab foi 2,0 (variação 1-6). Dezenove pacientes res- ponderam aos questionários através de contato telefônico. As principais causas de interrupção do tratamento foram o resultado visual abaixo do esperado (8 casos, 42,1%), a falta de informação sobre o controle clínico oftalmológico (5 ca- sos, 26,3%) e comorbidades sistêmicas (3 casos, 15,8%). Con- clusão: Um elevado número de pacientes interrompeu o acompanhamento após início de terapia intravítrea com be- vacizumab. Muitos deles referiram causas evitáveis de des- continuação do tratamento. Esforços devem ser feitos para propiciar informação mais adequada aos portadores de de- generação macular relacionada à idade exsudativa em vi- gência deste tratamento, especialmente com relação aos re- sultados funcionais e acompanhamento prolongado.
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Spectral-Domain Optical Coherence Tomography for Macular Edema

Spectral-Domain Optical Coherence Tomography for Macular Edema

he newest frontier in treating DME involves the use of anti-VEGF agents. Ranibizumab (Lucentis, Genentech, Inc., South San Francisco, CA), a monoclonal antibody fragment with binding ainity for VEGF-A, has been evalu- ated for treating DME [36]. Pilot studies found that intrav- itreal ranibizumab reduced macular edema on SD-OCT and improved VA in patients with DME [17]. Ranibizumab received Food and Drug Administration approval for treating DME based on the results of major clinical trials [37]. he beneits of ranibizumab for improving the VA and central foveal thickness on SD-OCT can be observed as early as 7 days ater treatment initiation; however, whether and for how long the beneicial efects of ranibizumab on retinopathy severity and progression persist ater therapy ces- sation also need to be determined [37]. Diabetic Retinopathy Clinical Research Network is also evaluating this question [38].
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Prognosis of VEGF inhibitors combined with laser therapy in patients with diabetic retinopathy

Prognosis of VEGF inhibitors combined with laser therapy in patients with diabetic retinopathy

adverse reactions of the two groups were basically the same, there was no significant difference(P>0. 05). 誗 CONCLUSION: VEGF inhibitors combined with laser therapy can effectively improve the curative effect of patients with diabetic retinopathy. It can effectively improve the retinal thickness and leakage of new blood vessels, and the patient蒺s vision, with good security. 誗 KEYWORDS: vascular endothelial growth factor inhibitors; laser therapy; diabetic retinopathy; visual acuity;safety

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Outcomes of Six Patients Who were Treated with Selective Embolisation Due to Arteriovenous Fistula Following Percutaneous Nephrolithotomy

Outcomes of Six Patients Who were Treated with Selective Embolisation Due to Arteriovenous Fistula Following Percutaneous Nephrolithotomy

Overall, a total of six patients were admitted to our clinic with delayed intermittent haematuria following PCNL procedures. Initially, patients were evaluated with non-contrast abdomen CT. Patients with the diagnosis of AVF by superselective angiography were then treated with selective embolisation. At the end of the procedure, angiography was repeated in order to conirm the occlusion of the vessel. Patients remained in bed with vital signs monitored every 4-6 hours following the procedure. A complete blood count was regularly performed until stabilisation of the condition. All patient characteristics, including age, sex, stone type, operation time, luoroscopy time, number of renal accesses, access site (subcostal or supracostal), calyx punctures, and number of blood transfusions were recorded. See Table 1 for patient characteristics.
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Effects of intravitreal bevacizumab injection on the clinical manifestations of nonproliferative diabetic retinopathy in patients with macular edema: a systematic review

Effects of intravitreal bevacizumab injection on the clinical manifestations of nonproliferative diabetic retinopathy in patients with macular edema: a systematic review

Since the clinical manifestations of NPDR stage in patients with diabetic retinopathy and macu- lar edema are associated with increased vascular permeability, in particular, VEGF levels, thera- peutic agents inhibiting VEGF may be used in the management of macular edema. Injection of IVB is considered as an effective VEGF inhibitor. It is also considered as a novel and effective therapy in the treatment of various ocular diseases such as retinal neovascularization, neovascular glaucoma, mac- ular edema, and other ocular complications (22- 24). Various studies have also demonstrated that IVB injection is a promising therapeutic agent in the management of patients with intraocular neo- vascular complication and macular edema (25). Previously, the safety and non-toxic effects of beva- cizumab on human retinal pigment epithelium, pig choroidal endothelial cells, and rat retinal gangli- ons had been demonstrated (24,26). Toxicological assessment of the topical bevacizumab had also been shown no significant adverse effects on ocu- lar epithelium and endothelium (27). As well, ther- apeutic potency of Avastin has been confirmed on iris rubeosis (28,29). Another study has shown that a single intravitreal ranibizumab (0.5 mg) injection Figure 1. Flowchart of study selection
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Elastic properties of the aorta and factors affecting aortic stiffness in patients with

Elastic properties of the aorta and factors affecting aortic stiffness in patients with

Materials and methods: Forty-six patients (25 male, mean age 47.3±6.5 years) with the diagnosis of MetS ac- cording to the Adult Treatment Panel III Final Report cri- teria were included. Forty-four age and gender matched healthy subjects (18 male, mean age 46.0±6.1 years) were recruited as the control group. Aortic strain, disten- sibility and stiffness index were calculated by M-mode echocardiography and diastolic parameters were mea- sured.

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Factors associated with depression in patients with Parkinson’s disease

Factors associated with depression in patients with Parkinson’s disease

Many of the studies report the frequency of depres- sion when utilizing a test that incorporates depression into its questionnaire, such as the NMSQuest Scale, which can overestimate or underestimate the presence of depression in patients with PD. It is therefore rec- ommended to use specific diagnostic tools to detect the presence of depressive symptoms in patients with PD. Our study assessed the presence of depression by using the BDI-II. This instrument is validated in the Spanish language, but not at the local level. It is thus important to validate its use in Peru for further investigations.
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Enhanced text spacing improves reading performance in individuals with macular disease.

Enhanced text spacing improves reading performance in individuals with macular disease.

Unlike the studies on inter-word spacing, previous studies on the effects of inter-line spacing have yielded mixed results that deserve careful consideration. With whole sentences, increased interline spacing was reported to yield either a small (though significant) increase in mean reading speed of macular disease patients [45] or no mean change at all [44]. The first of these studies is presumably more reliable than the second because it had a much larger sample size (N = 90 eyes, 61 observers versus N = 8 observers). The data from this study [45] are re-plotted in Figure 7. Improvements for individual observers (small open circles) produced by double line spacing ranged from below 10% to more than 40%. For comparison, results from four of our main conditions are re-plotted here in the same format (using large red and blue circles). Importantly, we can now see that for the text condition most comparable to that of Calabrese et al. [45] (word spacing =1, with high contrast; filled blue circle) our improvement in mean speed (19%) was similar to theirs (17%), despite a large difference in baseline reading speeds (see also Table 2). We agree with Calabrese et al. that these are modest improvements. But Figure 7 reinforces what we have already seen in Figure 5 – that doubling word spacing (red symbols) enhanced the effect of double line spacing, such that the improvement in mean speed increased to 26% with high contrast text and 46% with low contrast text (Table 2). Thus double-line and double-word Figure 2. Effect of word spacing with high contrast text. Reading speed (wpm) for single- versus double-character word spacing (bottom panels) and single- versus triple-character word spacing (top panels) for text passages with single, double or triple line spacing. Results shown are for reading text with a letter contrast of 87.5%.The individual data points in each panel show the results for each participant; the diagonal line in each panel is the ‘line of no effect’.
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Rev. bras. farmacogn.  vol.23 número6

Rev. bras. farmacogn. vol.23 número6

Calotropis procera (Aiton) W. T. Aiton, Apocynaceae, popularly known as “algodão-de-seda”, is a wild African bush, rich in bioactive substances that determine the medicinal potential of this species. Diabetes mellitus is a disease that affects about 10% of the population. This study aimed to evaluate the antihyperglycaemic activity of the hydroalcoholic extract of the leaves of C. procera of occurrence in coast of Pernambuco, Brazil. The hydroalcholic extract of the leaves of C. procera (300 and 600 mg/kg/day), vehicle, insulin (6U, s.c.) or metformin (500 mg/ kg/day) were administered orally to streptozotocin-induced diabetic rats (n = 7/group) for four weeks. Changes in body weight, food and water intake, biochemical markers, fasting glucose levels and oral glucose tolerance test were evaluated. The results showed that the C. procera dried extract (300 and 600 mg/kg) reduced significantly the level of blood glucose throughout the evaluation period and improved metabolic status of the animals and ameliorate the oral tolerance glucose test. The phytochemical screening revealed and quantified the presence of phenolic compounds and flavonoids in a percentage of 29.1 and 2.9%, respectively. Thus, we conclude that the extract of the leaves of C. procera has antihyperglycemic activity.
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Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

Abstract : Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The country’s system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The country’s ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were: to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH, to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH, to assess how access to technology affects the adoption of mHealth in maternal healthcare, to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial Gener al Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts, percentages, and measures of central tendency
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Two functional variants of IRF5 influence the development of macular edema in patients with non-anterior uveitis.

Two functional variants of IRF5 influence the development of macular edema in patients with non-anterior uveitis.

rs2004640 and rs10954213, influence the development of macular edema in uveitis patients, supported by a high statistical power; as shown in Table S2, the statistical power of our study is higher than 80% to detect the observed odds ratio (OR=1.5). It was not possible to determine whether these two genetic variants represent independent signals in uveitis, as previously reported in other autoimmune diseases. The fact that the conditional logistic regression analysis showed no conclusive results could be due to a reduced statistical power. On the other hand, no additive effect among these two functional IRF5 polymorphisms was evident, since the model considering a haplotype effect did not better explain the observed association than that of the independent SNPs. Nevertheless, this should be taken with caution, because a lack of statistical power could also represent a limitation in this analysis; indeed, the comparison of the goodness of fit of both models almost reached statistical significance. Regarding rs2070197, we found no evidence of association with non- anterior uveitis or clinical subphenotypes. However, the statistical power of this analysis was compromised due to the low frequency of the minor allele and, therefore, weak effects were hardly detected.
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Rev. Hosp. Clin.  vol.56 número1

Rev. Hosp. Clin. vol.56 número1

plus amoxicillin 1.0 g and clarithromycin 0.5 g bid. They show that the use of amoxicillin instead of tinidazole increases the eradication rate, which is similar to the results ob- served in developed countries. Side ef- fects were reported by 18% of our pa- tients, usually mild ones, therefore not interfering with adherence to treatment. Only one patient with persistent nau- sea and vomiting resulted in with- drawal from treatment. As observed by other investigators, we expected to find a higher eradication rate in males, since women would theoretically have been exposed to treatment with nitroimidazoles 30,31 more often, and
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Factors affecting the success of weaning in patients with chronic obstructive pulmonary disease

Factors affecting the success of weaning in patients with chronic obstructive pulmonary disease

Results: In 43 patients, 25 had successful weaning (58.1%). Patients with high APACHE II score prior to intu- bation was found as associated with weaning failure. High Glasgow coma scale (GCS) scores before entubation and weaning are associated with weaning success. Pre- weaning anxiety, positive endotracheal aspirate culture, pulmonary arterial pressure value, enteral feeding, pre- weaning tachycardia, pre-weaning cuff leaking and FiO 2 values were found to be associated with weaning failure. Pre-weaning cortisol levels were associated with wean- ing success. In successful weaning group, measured NIF and VT in spontaneous mode were found as higher and f/VT ratio was lower compared with unsuccessful group. T-tube during the 15 th and 30 th minutes of the symptoms
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